Hip Pain Assessment - Keeping it Relevant

I recently treated a lady suffering from hip pain every time she climbed into bed. After watching her demonstrate this task in the treatment room a few times, it became clear a change of technique was needed.

As a Chartered Physiotherapist, we are taught many tests to apply to the body when a client presents with pain. Some of these tests are done in order to determine which structures may be at fault, others to assess the amount of pain free movement available as well as the quality or ‘how well’ the joints are moving in relation to each other.

This is all well and good, as long as the assessment findings are relevant to the clients problem.

Unfortunately, this is not always the case - if you look for problems, inevitably you will find some.
So the physiotherapist must always be asking ‘is this important or relevant?’

Meaningful Task Analysis

With this in mind, an effective assessment approach is the Meaningful Task Analysis (MTA).

MTA involves looking at the problem from a more functional point of view. The Physiotherapist will ask the client to ‘show me what is causing you pain’ for example. It then becomes clear what movement is causing the pain and treatment can be immediately directed in a specific and relevant way to progress the desired outcome.

In some cases all that is required is a change in ‘how’ the task is performed without the need for any additional intervention.

When such a technique change is clearly necessary but also in itself presents related pain, treatment such as manual therapy, specific exercise and acupuncture / dry needling can be used to assist the quicker adoption of the new technique by relieving the pain and improving mobility.

Back to my client with the hip pain

We practiced a new way of getting into bed which involved less strain to the low back and hips. A follow up assessment a week later revealed no further pain was being experienced for this simple task. Simple as that.

This reminded me of the importance of MTA as part of the assessment process ensuring the treatment remains focused on solving the most relevant problem as quickly as possible.

By Simon Coghlan.